Quercetin is a major flavonol, one of the almost 4,000 flavonoids (antioxidants) that occur in foods of plant origin, such as red wine, onions, green tea, apples, berries, and Brassica vegetables (cabbage, broccoli, cauliflower, turnips). Quercetin is also found in Gingko biloba, St. John's wort, and American elder.

Quercetin and rutin (another flavonol) are used in many countries as vasoprotectants (protects blood vessels) and are ingredients of numerous multivitamin preparations and herbal remedies. They occur mainly as glycosides, which means they are linked with various sugars. However, the ability of the body to absorb these compounds is questionable.

Quercetin and other flavonols have a wide variety of biological effects, but the scientific evidence for use in the prevention or treatment of disease is weak. Quercetin has been considered as a therapy for cardiovascular diseases, high cholesterol, diabetic cataracts, inflammation, ischemic injury, chronic prostatitis, chronic venous insufficiency, gastrointestinal ulceration, hepatitis, allergies, asthma, viral infections, and hay fever.

Review of the literature shows that there have been several studies on the association of quercetin and with the risk reduction for coronary heart disease and stroke, high blood pressure, cancers, and a few studies on other medical conditions. However, there is a lack of strong evidence to support any of these conditions.

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

GRADE *

Several of the effects of flavonoids that have been observed in laboratory and animal studies suggest that they might be effective in reducing cardiovascular disease risk. Studies in humans using polyphenolic compounds from red grapes showed improvement in endothelial function in patients with coronary heart disease. Antioxidant and cholesterol-lowering effects are proposed.

Quercetin does not appear to affect changes in the immune system caused by intense exercise. However, it reduced the number of respiratory tract infections in people who participated in intense cycling. More research is needed.

C

Some research suggests that quercetin may help prevent pancreatic cancer in smokers. However, quercetin did not have this effect in non-smokers or former smokers. More research is needed to determine if quercetin is beneficial.

C

There is some evidence that quercetin may be useful for the treatment of chronic prostatitis and chronic pelvic pain syndrome. Further research is needed to confirm these results.

C

* Key to grades

A: Strong scientific evidence for this useB: Good scientific evidence for this useC: Unclear scientific evidence for this useD: Fair scientific evidence for this use (it may not work)F: Strong scientific evidence against this use (it likley does not work)

Tradition / Theory
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below.

It has been suggested that quercetin should be taken 20 minutes before meals. Quercetin has been ingested from onions, juice, black tea, and red wine. Doses of 100-500 milligrams of quercetin have been taken 2-3 times daily. It is available in tablet, capsule, or softgel form. Intravenous and intramuscular forms have been injected by a healthcare provider.

Children (under 18 years old)

Insufficient available evidence to recommend.

Safety
The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies

Avoid in individuals with a known allergy/hypersensitivity to quercetin by ingestion or skin contact. Eye, skin, gastrointestinal and/or respiratory tract irritation is possible.

Side Effects and Warnings

Being a common food component, quercetin is generally safe and well tolerated at usual dietary intake. However it has been associated with headache, gastrointestinal effects, hematoma, and kidney toxicity.

Intravenous injection has been associated with pain at the injection site that is dose related and can be controlled by reducing the rate of infusion. Intravenous administration of quercetin has also resulted in flushing, sweating, difficulty breathing (dyspnea), nausea, mild tingling of the extremities, lethargy, and vomiting.

Concern had been expressed about the possible tumor-promoting effect of quercetin.

Mild constipation and hair thinning were reported by two of 260 patients taking AS195, which contains red vine leaf extract that is rich in quercetin.

Based on laboratory study, platelet aggregation may be inhibited, which may increase bleeding risk.

Based on laboratory study, quercetin may enhance the effects of the cancer chemotherapy drug busulphan. Quercetin may decrease liver and kidney damage caused by the cancer chemotherapy drug cisplatin. Quercetin may also affect the levels of cyclosporine.

Quercetin may increase the effects of steroids or interact with estradiol and nifedipine by interfering with the way that the liver breaks them down.

Quercetin may interact with quinolone antibiotics like ciprofloxacin or levofloxacin.

Based on laboratory studies, short-term use of quercetin may result in higher uptake or influx of ritonavir and erythromycin. Quercetin may also inhibit cortisol.

Based on studies performed in animals and humans, quercetin supplementation may reduce blood pressure in people with hypertension.

Interactions with Herbs and Dietary Supplements

Quercetin may interact with herbs or supplements that are broken down by the liver.

Based on laboratory study, platelet aggregation may be inhibited that may increase bleeding risk.

Quercetin is found in elder, St. John's wort, parsley, green tea, and ginkgo, and thus there may be additive effects if taken together. Consumption of black currants, lingonberries, and bilberries increases quercetin levels in the blood.

Papain or bromelain may increase the absorption of quercetin. Vitamin C may enhance the antioxidant activity of quercetin. Consumption of rutin-containing herbs may cause additive effects due to quercetin content.

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.